Device and method for testing for a corset or spinal orthose

ABSTRACT

The present invention relates to a device and a method for testing out a spinal orthose or corset on a patient, whereby the device consists of a frame (2), which is width and height adjustable, a back beam (3), a back plate (16) with a support means (17, 18, 19, 22, 23, 25) belonging thereto and an abdominal plate (26). The device (1) is fixed on the back of the patient by adjusting the frame to the correct height and width, whereafter the back plate is fixed in the correct position by means of the support means. The values measured in such a way are transferred to a corset blank by means of a measurement rod (36) (FIG. 1).

FIELD OF THE INVENTION

The invention defines a device and a method for testing for a spinalorthose or corset for orthophedic use on back disorders.

PRIOR ART

Spinal orthoses or corsets of different shapes are of great use inmedical therapy to relieve the pain of various back disorders and, infact, are one of the most commonly prescribed technical facilitieswithin the orthopedic field. About 50,000 corsets are prescribedannually in Sweden. By the expression "corsets" is henceforward intendedits broadest meaning, i.e. cloth as well as plastic corsets (orthoses).Without any doubts they have any many times a good effect on differentpain conditions in the loins, but often corsets are prescribed onuncertain indications, which entails that the patients with backdisorders do not get the desired palliation of their pains and for thisreason do not use the corset. It is therefore important to get as clearindications as possible from the beginning if a corset should beprescribed and moreover how it should be shaped. This should be donebefore the manufacture and delivery of the corset. This is not of theleast economical importance, since the costs of corsets for medical useare high 50,000 corsets are ordinated yearly in Sweden at present.

The fact that corsets in many cases are of great importance forpalliation of the suffering of patients with back disorders and forallowing increased mobility is evident. This is especially true when theback pain is related to a position or a movement, i.e. if the paindecreases or disappears in certain positions, e.g. when a patient islying, sitting, or in a bent forward position. However, it is veryimportant that the corset is specially shaped and adjusted for thepatient in question, since different patients have different kinds ofpain as well as different shapes of the back.

Today standard corsets of cloth or plastic with a certain prefabricatedform of saddle support and abdominal pressure are used. However, it hasbeen found that the patient at mechanically caused pain conditions inthe loins, obtains a maximal palliation of pain with the corset only ina certain position of the loins. This entails that patients with astandard corset do not always obtain the desired palliation of theirpains, by the fact that the corset is not correctly shaped and for thisreason the patient does not use his corset.

Another reason for not using the corset is that sometimes the patientssuffer from stomach pains, like catarrhal gastritis etc. and for thisreason they cannot stand the abdominal pressure, which is necessary forsupporting the back. Thus, these patients should have been dissuadedfrom using a corset.

Several investigations have been made to establish the results of corsettreatment. In an investigation of Ahlgren S.A. and Hansen T "The use oflumbosacral corsets prescribed for low back pain", Prostheth, Ortop,3nt, 2:101-104, 1978 it was found that around three fourths of thepatients with back pains who had received corsets were using the same.Of the patients who four years later still suffered from back disorderstwo thirds used their orthos and they were of the opinion that they hadmore or less benefit from the use thereof. In another publication ofMcKenzie A.R. and Lipscomb (1979) it was discovered that only 50 percentof the patients who were prescribed a corset stated a clear improvement.

The purpose of the corset treatment is greatly to allow a mobilizationof the patient but still to avoid strain of the loins, i.e. to obtainpainlessness.

Imaginable causes for lumbosacral pains have been previously discussedand the effect of the corset thereon have also been discussed in theliterature, but are still not made clear. Imaginable facts which affectthe effect of the corset on the condition of the illness are:

1. immobilization of the vertebral column

2. stabilization

3. decreased intradiscal pressure by means of increased intraabdominalpressure

4. increase of the intraspinal space by lordotisation of the loins.

Probably the cause could be found within several of these possibilities.

Patients with lumbago acuta are usually free from pain if keeping theback completely still and many patients with this kind of pain do alsostate an improvement when using a corset.

The stability of the back is above all determined by the muscles of thetrunk. This is also affected by an increased intrathoral andintraabdominal pressure, which increases the load on the disks but whichalso stabilizes the vertebral column. The corset is assumed to increasethe stability and many patients with symptoms of back sufficience becomefree of pain when using the same.

An object with the present invention is to provide a device, by means ofwhich a correctly shaped corset can be manufactured. By means of thisdevice it is possible to establish whether a corset on the whole can beexpected to give any result and in that case how the corset should beshaped in order to give optimal result.

Another object with the present invention is to provide a method for fora corset, whereby the measurements which are measured by aid of theinstrument simply can be transferred to a corset blank.

SUMMARY OF THE INVENTION

In order to overcome the above mentioned disadvantages and to achievethe objects stated a device for trying out a corset on a patient isprovided according to the present invention, whereby the devicecomprises a frame, which surrounds the back of the patient and is widthand height adjustable: an adjustable back beam attached to the frame; aback plate, which is movably attached to the back beam; an abdominalplate for distribution of the pressure against the abdomen of thepatient, and a measurement rod for transferring the values set to acorset blank by aid of the frame, the back beam and the back plate.

Moreover, a method for trying for a corset on a patient is provided,whereby the height and width of the back of a patient are set by meansof an adjustable frame; the elevation position of the saddle on thepatient and the depth of the saddle is measured by means of anadjustable back beam and back plate coupled to the frame by means of anadjustable carrier device, and finally these measured values aretransferred to a corset blank by a measurement rod.

BRIEF DESCRIPTION OF THE INVENTION

FIG. 1 is a perspective view, from behind, of an embodiment of thedevice according to the invention.

FIG. 2 is a detail view of the setting means for the device shown inFIG. 1, seen along line I--I in FIG. 1.

FIG. 3 is a perspective view of the embodiment shown in FIG. 1, seenfrom the front, and FIG. 4 is a view of a transfer instrument, which isused at the device according to the invention to transfer measuredmeasurements.

DETAILED SPECIFICATION OF THE INVENTION

With regard especially to FIG. 1 an embodiment of a device 1 accordingto the invention is shown, which device comprises a frame 2, combinedwth two lower clamps 3, two upper clamps 4, and a back beam 5. The upperand the lower clamps are angled so that they essentially follow the backwith a smooth, straight portion and follow the side by means of aportion angled in relation to the straight portion. From the angledportion a straight portion runs downwardly along the side of the body.The back beam is at its upper end connected to the upper clamp 4 via aT-shaped portion 7, which in its turn is attached to and hold togetherthe upper clamps 4. The lower end of the back beam is in a correspondingway attached to the lower clamps 3. Screws 8 are inserted in grooves 9in the lower clamps 3 and the screws are threaded in the T-shapedportion 6. When the screws are not tightened the lower clamps 3 can bedisplaced laterally to a desired lower width for the device andthereafter be braced in position by means of the screws 8. in the sameway the upper clamps 4 are attached to the upper T-shaped portion 7 ofthe back beam 5 with screws 10 in the grooves 11.

Those portions of the clamps 3 and 4 which run sideways are connected bymeans of a similar arrangement, two screws 12 are at each side threadedin the lower clamp 3 and pass through a groove 13 in the upper clamp inorder to adjust the height of the device. For the purpose of adjustingthe height the back beam 5 also consists of two telescopically connectedportions 5A and 5B, whereby a screw 14 is threaded in the upper portion5B and passes through a groove 15 in the lower portion 5A.

On the back beam 5 is arranged a unit for setting of the saddle support,comprising a back plate 16, manufactured by a material which showsflexibility as well as stability, e.g. plastic, which plate is attachedto an insert 17. On each side of the insert 17 are positioned lower rods18 and upper rods 19. The upper rods 19 are rotatably attached with apin on each side of the insert 15 and extend from the insert andupwardly to grooves 21 in the side of the back beam, where they areattached at a through pin which runs in the grooves 21. The lower rods18 are attached in the same way and extend from the insert and upwardlyagainst the grooves 20.

The depth of the saddle support, i.e. the distance a, in FIG. 2, betweenthe back beam and the back plate 16, is adjusted by means of a screw 22,which is threaded in a plate 25 positioned inside the back beam andwhich passes through a fastener 23 on the upper side of the beam andthrough a groove 24 in the beam. The screw 22 is rotatably attached inthe insert 17. The elevation level of the saddle support can be adjustedby displacement of the back plate along the back beam 5, whereby thescrew 22 runs in the groove 24 and the rods 18, 19 run in the grooves20, 21. A certain level is fixed by clasping the fastener 23 which isthreaded to the screw 22.

A certain abdominal pressure is provided by means of an abdominalpressure plate or abdominal plate 26, which by means of three straps 27,28 and 29 are braced against the abdomen of the patient. This is bestillustrated by FIG. 3, but also by FIG. 1. Each strap consists of twoportions, which are connected with a buckle 30 and the abdominal plate26 is removably attached to the straps by means of Velcro tapes. In FIG.3 this attachment is i.a. shown between a longitudinal Velcro tape 41 onthe abdominal plate and Velcro tapes 42 attached on the inner side ofeach strap. On the inner side of the abdominal plate are also suitablyVelcro tapes (not shown) by means of which it is possible to attach acushion or pelott (not shown) for the purposes of allowing an adjustmentof the distribution and size of the abdominal pressure. The straps 27,28 and 29 are attached in grooves 31, 32 and 33, respectively in thesides 3, 4 of the clamps. The upper clamps 33 are longer than theremaining grooves and have suitably a length which corresponds to thedouble width of the strap so that the upper strap 29 can be displacedand that the device thereby can be adjusted to the constitution of thepatient.

The clamps 3 and 4 are furthermore provided with linings 34, 35,preferably of plastic which surrounds the back of the patient.

The linings 34, 35 protect the patient from direct contact with themetal frame and above all aim at giving the patient about the samefeeling as a later corset will give. One of the very purposes of thepresent invention is--as exactly as possible--to imitate a corset, inorder to be able to decide whether a corset is the correct ordination.

The device also comprises an measurement rod 36, which is constructedsimilar to the back beam 5 and which consists of two telescopicallyconnected portions 36A and 36B, which can be fixed in relation to eachother by aid of a screw 37. A measuring screw 38 is positioned in agroove throught the measurement rod and can be put in an optional alongthe measurement rod in the same way as the screw 22 on the back beam 5.By means of the measurement rod 36 the measures obtained via the frame2, the back beam 5 and the back plate 16 with an adjustable supportmeans is to be transferred to a corset blank. At the transfer themeasurement rod is placed beside the back beam with support against theframe.

The device is used in the following way. The screws 8, 10, 12 and 14 areloosened and the back plate is screwed back against the screw 22 as faras possible. The device is thereafter placed on the back of the patientso that the curvature of the lower clamp 3 is steadily placed over theilium (the christa edges). Thereupon the height is adjusted so that theupper clamps 4 will be positioned by the lower edge of the shoulderblades (scapula) but do not prevent its movement, whereby the elevationadjustment screws 12 and 14, respectively, are clamped.

Then the upper (4) and lower (3) clamps, respectively, are pressedtogether so that the sides of the clamps lie against the body,whereafter the side adjustment screws 8, 10 are fastened. Thereupon asuitable abdominal plate 26 is chosen and positioned with its lowerportion resting on the pubic bone (pubis). Suitably at least twodifferent abdominal plates are prepared; one for shorter patients andone for taller ones. If required, loose cushions can be placed insidethe plate 26. Then the buckles of the straps 27, 28 and 29 are attachedon the front of the Velcro tapes of the plate 26 and the straps aretightened so that the device steadily fits the body. Thereby thefastener 23 is, which is positioned in the back beam 5 is loosened, sothat the plate can run freely in the groove 24. Now the centre of theback plate is placed above the area where the optimal effect of thepressure can be expected, usually in the maximal inclination (the vertexof the lordosis, whereupon the fastener 23 is clamped. Then the backplate 16 is screwed up until the patient experiences that the back is inthe position where the pain is at a minimum or disappears. If thepatient now is able to move from the front and backwards(anterio-posterio) in the device this means that the abdominal pressureis too low and extra cushions must then be inserted between the patientand the abdominal plate 26. By screwing out the back plate 16 so that itno longer rests against the back, the buckles are loosened in the frontand a cushion is inserted. Thereupon the straps are fastened as tightlyas the patient may accept and the back plate 16 is once more screwed onuntil the patient is out of pain. It is then controlled that the patientcan no longer move anterio-posterio.

When the correct shape for the corset to come has been measured and alsochecked with the patient that the corset will be accepted, the measuredvalues should be transferred to a corset blank. This is made means ofthe measurement rod 36, which is shown in FIG. 4 and by means of whichthe position as well as the size of the inclination of the saddle ismeasured. After removing the device from the back of the patient, withthe measured positions well fixed, the measurement rod is placed besideand adjacent the back beam 5. By means of the screw 37 the measurementrod is adjusted to the same length as the back beam 5. The measurementscrew 38 is moved along with the measurement rod so that it will be atthe same level as the screw 22 and the fastener 23 and thereupon themeasurement screw is screwed up until it touches the back plate 16. Withthe iliac crest as a reference line the distance to the measurementscrew 38 is then measured and a measurement of the level for the maximuminclination of the saddle is obtained, and its distance in relation tothe reference line. These measurements are transferred to a corsetblank. The width of the corset is chosen according to standards.

A suitable corset blank is chosen and a hole in the back of the corsetblank is drilled, where the measurement screw 38 will pass and themeasurement rod is placed against the rear side of the blank with themeasurement screw 38 through the drilled hole. The saddle support canthen be built-up by means of bars on the inner side of the corset to anexact level and inclination. Regarding the material for the device theframe is suitably made of aluminum, while the linings together with theback plate and the abdominal plate are suitably made of stiff, flexibleplastic. However, other materials can be suitable. By aid of thedescribed device it is thus possible to manufacture especially adjustedcorsets for patients and also on a very early stage it can be decidedwhether a corset is the correct treatment in each individual case.

A better assistance can be given to those patients who are to be treatedwith corsets through the individual embodiment, and large costs areavoided due to erroneous ordinations of corsets. For the patients not tobe treated with a corset the advantage is achieved that without anyextra delay it is possible to change to another form of treatment.

In the specification above a preferred embodiment of the invention isdefined, which, however, can be modified by a person skilled in the art.The invention is only restricted to the accompanying claims.

I claim:
 1. A device for testing a patient for a spinal orthose orcorset, the device comprising: a frame (1) for surrounding the back of apatient, the frame being width and height adjustable; an adjustable backbeam (5) attached to the frame; a back plate (16) movably attached tothe back beam (5); and an abdominal plate (26) attached to the frame (1)for distribution of pressure against the abdomen of the patient; incombination with a measurement rod (36) for transferring values setthereon by the frame (1), back beam (5) and back plate (16) to a corsetblank; the frame (1) comprising two lower clamps (3) and two upperclamps (4), the clamps being adjustable in relation to each other forthe width and height adjustment of the frame, the lower clamps (3) beingattached to each other with screws (8) inserted in grooves (9) in thelower clamps, the upper clamps (4) being attached to each other withscrews (10) inserted in grooves (11) in the upper clamps, and both thelower and upper clamps (3, 4) being attached to the adjustable back beam(5).
 2. A device according to claim 1, characterized in that the backbeam (5) consists of two telescopically connected portions (5A, 5B). 3.A device according to claim 1, characterized in that the back plate (16)is mounted inside the back beam (5) by means of an adjustable supportmeans (17, 18, 19, 22, 23, 25) so that the back plate can be adjusted inan optional position along the back beam (5) and in a positioneddisplaced from the back beam.
 4. A device according to claim 1,characterized in that the measurement rod (36) consists of twotelescopically connected portions (36A, 36B).
 5. A device according toclaim 4, characterized in that the measurement rod moreover is equippedwith adjustment means (37-40) for transfer of the set values of the backbeam (5).
 6. A method for testing a patient for a spinal orthose orcorset, comprising:providing a movable back plate on a back beamadjustably on a frame for surrounding the back of a patient's body;measuring set elevation and depth position values of the back plate andbeam relative to the frame with a measuring rod for determiningcorresponding elevation and depth positions of the saddle of thepatient's back; and transferring the set values to a corset.
 7. A methodaccording to claim 6, characterized in that the measurement device isplaced on the frame alongside the back support whereby the transfer ofthe set values to the corset blank is made in such away that the lengthof the measurement device is adjusted so that it agrees with the lengthof the back support, the elevation level of the back plate and itsposition towards the body of the patient in relation to the back beam.